Beating-Heart, Off-Pump Coronary Artery Bypass Surgery

Our surgeons perform beating-heart surgeries because they have observed that heart function is better preserved if the heart is not stopped during an operation. This is especially true with high-risk cases, in which the heart is less able to bounce back after surgery.

• What is beating-heart coronary artery bypass surgery? How is it performed?
• What are the benefits of beating-heart bypass surgery?
• Who is a candidate for the beating-heart approach?
• Is beating-heart bypass surgery widely available? What's different about beating-heart bypass surgery performed by physicians from the University of Chicago Medicine?

*The procedure described on this page involves an open-chest approach. For information about minimally invasive beating-heart bypass surgery, read about coronary artery bypass surgery through a mini thoracotomy (ThoraCAB).

Q. What is beating-heart coronary artery bypass surgery? How is it performed?
A. In an open-chest, beating-heart bypass procedure, surgeons make an incision through the breastbone to gain access to the heart. In many cases, surgeons do a partial sternotomy--which is a shorter incision through the breastbone than a full sternotomy. Unlike traditional bypass surgery, the heart is not stopped during a beating-heart bypass procedure. This approach uses special devices to stabilize the part of the heart the surgeon is operating on.

At the University of Chicago Medicine, beating-heart bypass is typically performed without the use of a heart-lung bypass machine, though it may be performed with the support of the machine in select cases.

Q. What are the benefits of beating-heart bypass surgery?
A. In comparison to traditional bypass surgery, the benefits of beating-heart bypass surgery include:

• Quicker recovery
• Reduced hospital stay
• Reduced risk of neurological injury, including stroke and damage to the memory function
• Better preservation of heart function
• Less chance for heart rhythm, kidney, or liver complications
• Better survival rate, especially among high-risk patients

Q. Who is a candidate for the beating-heart approach?
A. Most people who require coronary artery bypass graft surgery are candidates for the beating-heart approach. Surgeons weigh several factors, such as the location of blocked arteries, a patient's history of past thoracic surgeries, and the presence of co-existing diseases. Patients with very poor heart function, cases that require reoperation involving the side of the heart, and hearts that are unable to tolerate manipulation may not be appropriate for this approach.

Q. Is beating-heart bypass surgery widely available? What's different about beating-heart bypass surgery performed by physicians from the University of Chicago Medicine?
A. More than 80 percent of coronary bypass surgeries performed at the University of Chicago are done on a beating heart. No other hospital in the greater Chicago area performs such a high percentage of beating-heart bypass procedures. Although beating-heart bypass is not an option for all patients requiring bypass surgery, our experienced surgeons are frequently able to offer it safely to many patients refused for beating-heart bypass by other hospitals.

For high-risk patients, such as the elderly or those who have had multiple open-heart procedures, our surgeons can offer sternal plating, a method that secures the breastbone after open-heart surgery to help it heal properly. University of Chicago surgeons developed sternal plating. Rather than securing the breastbone with wires after the procedure, surgeons use small titanium plates to rejoin it. This approach has dramatically decreased the number of patients who develop post-operative infections or pain caused by separation of the bone. »Learn more about sternal plating

More Information

• ThoraCAB: Mini Thoracotomy Bypass
• Off-Pump, Beating-Heart Bypass
• Traditional Open Bypass